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8321. Hypertension in Pregnancy

concentration (20 U/500 ml N/s or Ringers) and the volume of fluid included in the total input. Oliguria at this point should not precipitate any specific intervention except to lower thresholds for considering early delivery. As these women are at high risk of Caesarean section, oral fluids should also be limited. • Oxygen saturation should be measured continuously and charted with blood pressure. If saturation falls below 95% then medical review is essential. 1. Initially check BP manually and compare (...) • Unfractionated heparin 5000 IU sc twice daily (bid) should be given until the woman is fully mobile. A prophylactic dose of low molecular weight heparin (LMWH) can be used postpartum. 19,20 • Many clinicians do not see the use of unfractionated heparin as a contraindication to the insertion of an epidural, providing there is no evidence of a coagulopathy. Ideally the epidural would be inserted 1 hour prior to the next dose of unfractionated heparin, as there is a subset of patient who become therapeutically

2006 British Columbia Perinatal Health Program

8322. Medical Reports - Dealing with Requests

of support for exemption from jury service Illness as grounds for entitlement Exemptions from paying medical and maternity prescriptions (FP92A, FW8) Housing letters Social security letters Forms related to disabled parking badges Forms for disability and mobility allowance War pensions Holiday insurance cancellation or curtailment Accounts of medical events for civil proceedings Fitness to engage in a particular occupation or profession Health Professions Council PCV and LGV licences Taxi driver Summer (...) not want divulged. [ ] A common format for General Practitioner Report (GPR) has been agreed and computer-generated reports (eGPR) are accepted by insurers. Many GP software programs now have the facility to generate reports from within their systems, merging all relevant patient data. It is, however, still necessary for the GP to check that the data are complete and accurate before submitting the report. Non-medical reports Countersigning passport applications and confirming identity are examples

2008 Mentor

8323. Improving outcomes in breast cancer

/nhsplan-e.pdf 3. A Policy Framework for Commissioning Cancer Services: A Report by the Expert Advisory Group on Cancer to the Chief Medical Officers of England and Wales (1995). Available from: http://www.doh.gov.uk/cancer/pdfs/calman-hine.pdf Related NICE publications: Completed appraisals • National Institute for Clinical Excellence (2001) Guidance on the use of taxanes for the treatment of breast cancer. NICE Technology Appraisal Guidance No. 30. London: National Institute for Clinical Excellence (...) on Medical and Population Subjects no.66. The Stationery Office: London 2001. Country No of Incidence: No of deaths Mortality: registrations crude rate per (2000) crude rate per (1998)100,000 100,000 (1998) (2000) England 32,908 131.0 10,609 41.9 Wales 1,914 128.05 731 48.7particularly apparent among women aged 50-64; this is believed to be primarily due to earlier detection through the breast screening programme set up in 1988. Figure 1. Age-specific incidence of breast cancer, England and Wales, 1997

2002 National Institute for Health and Clinical Excellence - Clinical Guidelines

8324. Clinical practice guidelines for the psychosocial care of adults with cancer

Email: directorate@nbcc.org.au These guidelines were approved by the National Health and Medical Research Council at its 147th Session on 10 April 2003, under section 14A of the National Health and Medical Research Council Act 1992.Approval for the guidelines by NHMRC is granted for a period not exceeding five years, at which date the approval expires.The NHMRC expects that all guidelines will be reviewed no less than once every five years. Readers should check with the National Breast Cancer Centre (...) for any reviews or updates of these guidelines. The strategic intent of the NHMRC is to provide leadership and work with other relevant organisations to improve the health of all Australians by: • fostering and supporting a high quality and internationally recognised research base; • providing evidence based advice; • applying research evidence to health issues thus translating research into better health practice and outcomes; and • promoting informed debate on health and medical research, health

2003 National Breast and Ovarian Cancer Centre

8326. Tackling inequalities through the social determinants of health: Building the evidence base

were greater for adults and female youth than for young males. Acevedo-Garcia et al’s (2004) review examined a wider range of housing mobility policies with a closer focus on health outcomes; [10] like the previous review, it examined housing mobility, but also included housing policy for the mentally ill. Their conclusions were that housing mobility policies (at least in the US) result in improvements in health and health behaviours, though the number of studies is small. They concluded (...) that housing mobility policies (at least in the US) do improve health and health behaviours, though research on the mechanisms is required. General housing improvement is also associated with positive change in social outcomes – such as reductions in fear of crime, and improvements in social and community outcomes (social participation), but where evidence on the effects on health is presented the effects are small. Although housing improvement often takes place within the context of regeneration

2007 Public Health Research Consortium

8327. National tobacco control policies: do they have a differential social impact?

by grants from the U.S. National Cancer Institute/NIH (from the Roswell Park Transdisciplinary Tobacco Use Research Center (TTURC), P50 CA111236, and from R01 CA100362), the Canadian Institutes for Health Research (#57897), Robert Wood Johnson Foundation (#045734), the Australian National Health and Medical Research Council (#265903), Cancer Research UK (#C312/A3726), the Australian Commonwealth Department of Health and Ageing, the Centre for Behavioural Research and Program Evaluation of the National (...) across the four countries over the study period UK CA US AU 2002 2003 2004 2005 TV Radio Movie - Billboards Newspapers/mags - - Advertising Store - - Sports - - - Sponsorship Arts - - - Free samples - Special price - - - Gift/discount - E-mail - - Mobile phone - - Direct mail - - Branded clothing - - - Competitions - - Internet sites - - Leaflets - - Promotions Signs - - - ( = complete ban , = partial

2006 Public Health Research Consortium

8328. Natural Orifice Translumenal Endoscopic Surgery for intra-abdominal surgery: a systematic review

into larger trials. NOTES procedures and studies should be performed under strict guidelines, such as the membership criteria developed by NOSCAR. - ASERNIP-S REVIEW OF NATURAL ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY (NOTES) TM FOR INTRA- ABDOMINAL SURGERY – JULY 2007 - vi Important note The information contained in this report is a distillation of the best available evidence located at the time the searches were completed as stated in the protocol. Please consult with your medical practitioner if you (...) - ABDOMINAL SURGERY – JULY 2007 - ix The ASERNIP-S Review Group ASERNIP-S Director Professor Guy Maddern, FRACS ASERNIP-S Royal Australasian College of Surgeons Stepney SA 5069 Protocol Surgeon Dr Ian J Martin, FRACS Wesley Medical Centre Auchenflower Brisbane 4066 Advisory Surgeons Mr Thomas Graham Wilson, FRACS Consultant Surgeon Flinders Medical Centre Bedford Park SA 5041 Mr Nicholas O’Rourke, FRACS Royal Brisbane Hospital Brisbane QLD 4001 ASERNIP-S Researcher Ms Eliana Della Flora ASERNIP-S Royal

2007 ASERNIP-S

8329. Developing and Sustaining Effective Staffing and Workload Practices

Registered Nurses’ Association of Ontario Toronto, Ontario Cheryl Beemer, RN Staff Nurse Hamilton Health Sciences Centre Hamilton, Ontario Carol Dueck, RN, BScN, MCE Consultant, Patient Care Coordinator Healthtech Inc., Institute for Safe Medication Practices Canada West Lincoln Memorial Hospital Grimsby, Ontario Doris Grinspun, RN, MSN, PhD(c), O.ONT. Executive Director Registered Nurses’ Association of Ontario Toronto, Ontario Brenda Hallihan, RN Staff Nurse ICU Peterborough Regional Health Centre (...) Council Sunnybrook Health Sciences Centre Toronto, Ontario Betsy Jackson, RN, MScN Advanced Practice Nurse, Schulich Heart Program and Project Leader, Workload/ Scheduling Informatics Sunnybrook Health Sciences Centre Toronto, Ontario Darlene Kennedy, RN Nurse Manager, Cardiac Care, Cardiology, Medical Stepdown, Respirology Units St. Joseph's Health Care Hamilton, Ontario Catherine Kohm, RN, MEd Director of Nursing Baycrest Toronto, Ontario Marlene Kuri, RN, BScN, CNCC(C), MScPsych(c) Mental Health

2007 Registered Nurses' Association of Ontario

8330. Breastfeeding Best Practice Guidelines for Nurses

: Application of a rigorous scientific approach to the preparation of a review article (National Health and Medical Research Council, 1998). Systematic reviews establish where the effects of health care are consistent, and where research results can be applied across populations, settings, and differences in treatment (e.g., dose); and where effects may vary significantly. The use of explicit, systematic methods in reviews limits bias (systematic errors) and reduces chance effects, thus providing more (...) ; access to support for breastfeeding, including significant others and peers; attitude about breastfeeding among health care providers, significant others and peers; and physical factors, including breasts and nipples, that may effect a woman’s ability to breastfeed. * See page 14 for details regarding “Interpretation of the Evidence”11 Nursing Best Practice Guideline Practice 3.2 Key components of the postnatal assessment should include: III Recommendations intrapartum medications; (cont.) level

2003 Registered Nurses' Association of Ontario

8331. Reducing Foot Complications for People with Diabetes

, and application. From this appraisal process, four documents were identified as high quality, relevant guidelines and were selected as “foundation” documents for this guideline: American Diabetes Association (2001). Clinical practice recommendations 2001. Diabetes Care, 24(Suppl.1), S1-133. Canadian Diabetes Association (1998). 1998 clinical practice guidelines for the management of diabetes in Canada. Canadian Medical Association Journal, 159(Suppl.8), S1-S29. Institute for Clinical Systems Improvement (2000 (...) the recommendations of the guideline. The proposals underwent an external review process and the successful applicant (practice setting) selected. This guideline was implemented by a hospital and a community care organization in northern Ontario between April 2002 and July 2003. Four participating medical/oncology hospital units located at two sites in one community participated, as did the diabetic education and care centre, located at a third site. Nurses participating from the community care organization were

2004 Registered Nurses' Association of Ontario

8332. Nursing Care of Dyspnea:The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease

Review: Application of a rigorous scientific approach to the preparation of a review article (National Health and Medical Research Council, 1998). Systematic reviews establish where the effects of healthcare are consistent and research results can be applied across populations, settings, and differences in treatment (e.g., dose); and where effects may vary significantly. The use of explicit, systematic methods in reviews limits bias (systematic errors) and reduces chance effects, thus providing more (...) and Home Ventilator Training Programs, West Park Healthcare Centre, Toronto, Ontario Cynthia Giff, RN Nursing Director Medical/Surgical Units, Brockville General Hospital, Brockville, Ontario Dianne Husbands, BA, RN, BScN, MN(c) Educator, Chest Program, St. Joseph’s Healthcare, Hamilton, Ontario Khiroon Kay Khan, RN, CAE, Clinical Nurse Educator, Asthma and Airway Centre, University Health NARTC Diploma & Instructor in Network – Toronto Western Hospital, Toronto, Ontario Asthma and COPD Colleen Kenney

2005 Registered Nurses' Association of Ontario

8333. Assessment and Device Selection for Vascular Access

application, leadership and relationships; Practice Standard – Medication (2004f), which provides standards for nurses to administer medications safely and effectively in all practice settings; Practice Standard – Documentation (2004d), which outlines nurses’ professional accountability in record keeping, and the expectations for documentation for all nurses in direct practice; Practice Standard – Ethics (2004e), which describes the ethical values that are most important to the nursing profession (...) , including complications of diabetes, if applicable; Previous history of infusion therapy (peripheral or central) – devices, therapies, outcomes; Lifestyle – leisure/recreational activities and occupation; Language/cultural barriers; History of intravenous drug use; Medical and surgical history (e.g., diabetes, mastectomy, renal dialysis, immunocompromised, MRSA positive); Allergies (particularly latex); and Prognosis. 23 Nursing Best Practice GuidelineSupport System/Resources (Level IV) Infusion

2004 Registered Nurses' Association of Ontario

8334. Assessment and Management of Venous Leg Ulcers

all individuals or groups who will be directly or indirectly affected by the change or solution to the problem. Stakeholders can be of various types, and can be divided into opponents, supporters, and neutrals (Ontario Public Health Association, 1996). Systematic Review: Application of a rigorous scientific approach to the preparation of a review article (National Health and Medical Research Council, 1998). Systematic reviews establish where the effects of healthcare are consistent and research (...) Elaine Diebold Enterostomal Therapy Nurse Durham, Ontario Geneviève Grégoire Dietetic Intern Moncton, New Brunswick Connie Harris Enterostomal Therapist/Consultant Kitchener, Ontario Cheri Hernandez Associate Professor Faculty of Nursing University of Windsor Windsor, Ontario Dr. Pamela Houghton Associate Professor School of Physiotherapy University of Western Ontario London, Ontario Madge Legrace Registered Nurse Unionville, Ontario Dr. Ronald Mahler Dermatologist Thunder Bay Medical Centre Thunder

2004 Registered Nurses' Association of Ontario

8335. Stroke Assessment Across the Continuum of Care

Barreca, PT, BA Research Clinician, Orthopedic and Rehabilitation Services, Hamilton Health Sciences Centre. Hamilton, Ontario Mark Bayley, MD, FRCPC Assistant Professor, Faculty of Medicine, University of Toronto. Medical Director, Neuro-Rehab Program, Toronto Rehabilitation Institute, Toronto, Ontario Jennifer Bean, RN, BScN Utilization Coordinator – ED/ICU/Medicine, Northeastern Regional Education Coordinator. Thunder Bay Regional Health Science Centre. Thunder Bay, Ontario Sandy Beckett, BA, BSc (...) (PT) Clinical Supervisor Physiotherapy, Credit Valley Hospital. Mississauga, Ontario Gerald Bigham, Hon BA, MD Family Physician. Oxford Medical Centre. London, Ontario Cindy Bolton, RN, MBA Program Manager, Nursing Research Unit. Kingston General Hospital, Kingston, Ontario Michelle Bott, RN, BScN, MN Professional Practice Coordinator, Guelph General Hospital. Guelph, Ontario Corina Caila, RN RN Supervisor, Paramed Home Health Care. Orleans, Ontario Janice Cicoria, RN, BScN, CNN(c) Clinical

2005 Registered Nurses' Association of Ontario

8336. Caregiving Strategies for Older Adults with Delirium, Dementia and Depression

Disorganized thinking Consciousness altered Delirium Dementia Depression Risk Factors & Urgency Pay attention to: • Hearing/visual deficits* • Dehydration* • Sleep disturbances* • Existing dementia • Cognitive impairment* •Mobility/immobility* • Medications • Metabolic abnormalities • Comorbidity * Prevention factors Determine Nature & Severity Differentiate: • Mild • Moderate • Severe without psychosis • Severe with psychosis • Recurrent Determine suicidal ideation Determine urgency Prevention & Early (...) be of various types, and can be divided into opponents, supporters, and neutrals (Ontario Public Health Association, 1996). Systematic Review: Application of a rigorous scientific approach to the preparation of a review article (National Health and Medical Research Council, 1998). Systematic reviews establish where the effects of healthcare are consistent and research results can be applied across populations, settings, and differences in treatment (e.g., dose); and where effects may vary significantly

2004 Registered Nurses' Association of Ontario

8337. Screening for Delirium, Dementia and Depression in the Older Adult

. Stakeholders can be of various types, and can be divided into opponents, supporters, and neutrals (Ontario Public Health Association, 1996). Systematic Review: Application of a rigorous scientific approach to the preparation of a review article (National Health and Medical Research Council, 1998). Systematic reviews establish where the effects of healthcare are consistent and research results can be applied across populations, settings, and differences in treatment (e.g., dose); and where effects may vary (...) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Appendix N – Medications That May Cause Cognitive Impairments . . . . . . . . . . . . . . . 80 Appendix O – List of Available Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Appendix P – Description of the Toolkit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 10 Screening for Delirium, Dementia and Depression in Older Adults11 Nursing Best Practice Guideline Guiding Principles – Assumptions It is the consensus of the guideline

2003 Registered Nurses' Association of Ontario

8338. Woman Abuse: Screening, Identification and Initial Response

Associate Professor University of Western Ontario School of Nursing London, Ontario Mary Carter, RN, BScN, SANE Domestic Violence/Sexual Assault Treatment Program Sudbury Regional Hospital Sudbury, Ontario Mary Dempsey, RN, BA, SANE Sexual Assault/Domestic Violence Care Centre Nurse Facilitator Hamilton Health Sciences Centre McMaster University Medical Centre Hamilton, Ontario Kathleen Fitzgerald RN, BN, MHScN, SANE Manager, Sexual Assault/Partner Abuse Treatment Program Lake of the Woods District (...) , Healthy Babies, Healthy Children, Hastings and Prince Edward Counties Health Unit, Belleville, Ontario Jim Natis, BA, BSW, MSW, RSW Social Worker, University Health Network, Toronto General Hospital, Toronto, Ontario Marsha Olinski, RN, BScN Manager, Sexual Health Program, Hastings and Prince Edward Counties Health Unit, Belleville, Ontario Rosana Pellizzari, MD, CCFP , MSc, FRCPC Medical Officer of Health, Perth District Health Unit, Stratford, Ontario Ann Playne, RN Mental Health Therapist, Ann P

2005 Registered Nurses' Association of Ontario

8339. Assault/Abuse - safeguarding children

sexual activities, or encouraging children to behave in sexually inappropriate ways. Neglect is the persistent failure to meet a child’s basic physical and / or psychological needs, likely to result in the serious impairment of the child’s health or development. It may involve a parent or carer failing to provide Neglect adequate food, shelter and clothing, failing to protect a child from physical harm or danger, or the failure to ensure access to appropriate medical care or treatment. It may also (...) needs because of a psychological or medical dif?culty. For example, deaf or autistic children may demonstrate challenging behaviour, which may or may not be as a result of abuse. Children with special needs are more likely to be abused than children in the general population. Children in need Children who are de?ned as being ‘in need’ are those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development, or their health and development

2007 Joint Royal Colleges Ambulance Liaison Committee

8340. Trauma - neck and back trauma

no randomised controlled trials comparing out of hospital spinal immobilisation techniques 1 : ? soft collars do not limit movement 2,3 ? there is variable difference between the various types of semi-rigid collars 2-4 ? addition of side supports and tapes increases immobilisation 2,3 ? combining collar with extrication board improves immobilisation 5 ? the application of devices is more important than the variation of devices 6 ? neutral position needs slight ?exion of the neck and the occiput should (...) should have manual immobilisation commenced at the earliest time, whilst initial assessment is undertaken. HISTORY It is vital to determine the mechanism of injury in order to understand the forces involved in causing the injury including: hyper?exion, hyperextension, rotation and compression and combinations of all the above. Injury most frequently occurs at junctions of mobile and ?xed sections of the spine. Hence fractures are more commonly seen in the lower cervical vertebrae where the cervical

2007 Joint Royal Colleges Ambulance Liaison Committee

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